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Humeral shaft fracture

C Z Esenyel, I Kalkar, M Adaş, S S Dedeoğlu, C D Büyükkurt, H Cabuk, A E Esenyel
Objective: To evaluate the functional and radiological results of patients with and without medial calcar continuity in plate osteosynthesis applied for a proximal humerus fracture retrospectively. Methods: The study included 27 patients to whom plate osteosynthesis was applied because of a proximal humerus fracture between January 2, 2010, and December 30, 2013, at Okmeydanı Research and Training Hospital. Patients were separated into Group A with medial calcar continuity and Group B without medial calcar continuity...
March 2018: Nigerian Journal of Clinical Practice
Wei Huang, Kun Zhang, Yangjun Zhu, Zhan Wang, Zijun Li, Jun Zhang
A non-union, especially atrophic non-unions, is a permanent failure of healing following a fracture and can be difficult to treat. Approximately 5-10% of fractures will result in a non-union during the healing process. non-unions can be classified into two types: atrophic non-union which is often due to impaired bone healing with a potential biological mechanism, and hypertrophic non-union which is due to inadequate fixation after fracture. Genetic variations also play an important role in the fracture healing response...
2018: PloS One
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
Chao-Feng Zhao, Quan-Yang Gao, Tian-Jian Zhang, Lu-Li Han, Jun-Feng Zhao, Gang Chen, Yu Cui
OBJECTIVE: To explore the clinical effect of closed reduction and minimally invasive treatment of humeral shaft fractures in children. METHODS: From July 2011 to April 2015, 39 cases of pediatric humeral shaft fractures were treated by closed reduction and external fixation, including 27 males and 12 females with a mean age of 8.6 years old ranging from 3 to 14 years old. Time from injury to the treatment was 2 h to 7 days with an average of 2.7 days. There were 6 cases of upper fracture, 21 cases of middle fracture and 12 cases of lower fracture...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Raffaele Russo, Antonio Guastafierro, Livia Renata Pietroluongo
BACKGROUND: This study regards a volumetric analysis of proximal humeral fractures. The main purpose was to investigate the head displacement in relation to the shaft and its link to volume reductions ("bone loss") of the anatomic segments interposed between the head and the shaft: the tuberosities and the calcar. We call this area "control volume." METHODS: In 20 fractures, we used 3-dimensional virtual reconstruction to create a reference system that divides geometrically the control volume and allows the evaluation of displacement angles of the humeral head...
February 5, 2018: Journal of Shoulder and Elbow Surgery
Ali Jabran, Chris Peach, Zhenmin Zou, Lei Ren
BACKGROUND: Open reduction and internal fixation of proximal humerus fractures can be difficult to achieve adequate, complication free results due to osteopenia of the proximal humerus and unstable fracture patterns. This study aimed to compare the biomechanical properties of a novel hybrid fixed angle blade plate (Fx plate) with an established fixed angle locking plate (PHILOS plate). METHODS: A two-part fracture was simulated in synthetic composite humeri by creating a transverse osteotomy and 10 mm fracture gap at the surgical neck...
January 25, 2018: Biomedical Engineering Online
Selim Şanel, Yalçın Turhan, Nurullah Ermiş, Korhan Özkan, Ender Uğutmen
OBJECTIVES: Long head of the biceps tendon (LHB) is an obstacle to closed reduction in two-part fracture of the humeral surgical neck if the distal humeral shaft is displaced into the axilla in anteroposterior X-ray examination. METHODS AND MATERIAL: Among 36 proximal humeral fractures, 10 two-part humeral surgical neck fractures which were displaced into the axilla in anteroposterior X-ray views and classified as 11-A3.2 were included in this study. In all of these fractures, closed reduction attempts were unsuccessful...
January 23, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Giuseppe Rollo, Roberto Rotini, Paolo Pichierri, Marco Giaracuni, Alessandro Stasi, Luca Macchiarola, Michele Bisaccia, Luigi Meccariello
Background: Fractures of the proximal part of the humerus represent almost 4-5% of all fractures. The rate of non union is estimated to be 1.1 to 10%. Non union, displacement, and fixation failure can be hazardous complications for these injuries. The purpose of our study was to evaluate the outcomes of plate and bone strut allograft with bone chips grafting augmentation in the management of proximal humeral aseptic non union. Methods: We treated 16 aseptic non union proximal humeral fractures by the medial humeral shaft bone strut allograft and lateral plate and screws with bone chips grafting...
September 2017: Clinical Cases in Mineral and Bone Metabolism
Yong Sun, Hong-Sheng Shang, Wei-Hong Zhang, Jing-Ti Jing
OBJECTIVE: To observe the clinical effects of closed reduction and percutaneous double K-wires internal fixation in treating multisegmental fracture of humeral shaft. METHODS: From January 2009 to April 2015, 27 patients with multisegmental fracture of humeral shaft were treated with closed reduction and percutaneous double K-wires internal fixation, including 10 males and 17 females, ranging in age from 26 to 81 years with an average of 52 years;the disease course ranged from 2 hours to 6 days with an average of 1...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Sreekanth Kashayi-Chowdojirao, Aashish Vallurupalli, Vijay Krishna Chilakamarri, Chandrasekhar Patnala, Lalith Mohan Chodavarapu, Nageswara Rao Kancherla, Asif Hussain Khazi Syed
Background: Non-union humeral shaft fractures are seen frequently in clinical practice at about 2-10% in conservative management and 30% in surgically operated patients. Osteosynthesis using dynamic compression plate (DCP), intramedullary nailing, locking compression plate (LCP), Ilizarov technique along with bone grafting have been reported previously. In cases of prior failed plate-screw osteosynthesis the resultant osteopenia, cortical defect, bone loss, scalloping around screws and metallosis, make the management of non-union more complicated...
November 2017: Journal of Clinical Orthopaedics and Trauma
Cory K Mayfield, Kenneth A Egol
Arm wrestling places significant torque on the humeral shaft. A spiral distal humeral shaft fracture is an unusual but significant injury that can result. Of 93 patients who presented between 2009 and 2017 with closed humeral shaft fractures that were managed nonoperatively, 9 sustained the fractures while arm wrestling. Outcomes were compared with those of all other patients with nonoperatively managed humeral shaft fractures sustained through other mechanisms. The Student's t test was used to compare cohorts...
January 8, 2018: Orthopedics
Markus Rupp, Christoph Biehl, Matthäus Budak, Ulrich Thormann, Christian Heiss, Volker Alt
The intention of the current article is to review the epidemiology with related socioeconomic costs, pathophysiology, and treatment options for diaphyseal long bone delayed unions and nonunions. Diaphyseal nonunions in the tibia and in the femur are estimated to occur 4.6-8% after modern intramedullary nailing of closed fractures with an even much higher risk in open fractures. There is a high socioeconomic burden for long bone nonunions mainly driven by indirect costs, such as productivity losses due to long treatment duration...
December 22, 2017: International Orthopaedics
S Gunst, G Walch, L Nové-Josserand
Valgus-impacted proximal humerus fracture is a classic but rare entity in shoulder traumatology. Surgical treatment is controversial, with increasing use of minimally invasive techniques. Our technique uses a minimally invasive approach under fluoroscopic control. Raising the humeral head to reduce the valgus enables spontaneous and well-positioned reduction of the tuberosities and screw fixation between the greater tuberosity and the humeral shaft. Indications comprise valgus-impacted fracture without comminution of the medial epiphyseal-metaphyseal hinge or greater tuberosity; the rotator cuff contributes to reduction and must be intact...
December 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jagdeep Singh, Anoop Kalia, Kavin Khatri, Anshul Dahuja
Introduction: Humerus non-union is a challenging situation for the surgeon and devastating and morbid situation for the patient. Surgical approach to the humerus is demanding because of the complex neurovascular anatomy and especially when previous surgeries have been attempted. Case Report: We report a case of a young adult male who sustained a compound fracture of humerus shaft treated with intramedullary nailing followed by subsequent bone grafting and eventually landed up in non-union and was treated at our center by locking compression plate application with nail in situ with iliac crest autogenous bone graft followed by shoulder spica application...
September 2017: Journal of Orthopaedic Case Reports
Sang-Hun Ko, Jae-Ryong Cha, Chae Chil Lee, Yong Tae Joo, Kyeong Su Eom
Background: This study aims to compare the surgical outcomes of open reduction and internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) using a screw compression method in simple humeral shaft fractures. Methods: This retrospective study was performed with 50 patients who had surgical interventions for the treatment of simple humeral shaft fractures and had follow-ups of at least 12 months in Ulsan University Hospital between August 2008 and June 2015...
December 2017: Clinics in Orthopedic Surgery
Alvin Chao-Yu Chen, Chih-Hao Chiu, Kuo-Yau Hsu, Yi-Sheng Chan
BACKGROUND: The deltoid splitting approach has recently been widely adopted to facilitate less invasive procedures for proximal humerus fractures. However, there are still concerns regarding its effectiveness in aging people and in cases involving complex fractures. This study was conducted to evaluate the efficacy of a proximal humeral locking plate using the anterolateral deltoid splitting approach and to specifically examine the effect of patient age, gender, and fracture pattern on surgical outcomes...
November 28, 2017: BMC Musculoskeletal Disorders
Gerard Chang, Asif M Ilyas
Radial nerve palsies are a common complication associated with humeral shaft fractures. The authors propose classifying these injuries into 4 types based on intraoperative findings: type 1 stretch/neuropraxia, type 2 incarcerated, type 3 partial transection, and type 4 complete transection. The initial management of radial nerve palsies associated with closed fractures of the humerus remains a controversial topic, with early exploration reserved for open fractures, fractures that cannot achieve an adequate closed reduction requiring fracture repair, fractures with associated vascular injuries, and polytrauma patients...
February 2018: Hand Clinics
Niksa Kojic, Christoph Rangger, Celenk Özgün, Jakisa Lojpur, Jerome Mueller, Yoram Folman, Eyal Behrbalk, Bore Bakota
PURPOSE: This prospective pilot study investigated the safety and efficacy of a novel radiolucent intramedullary nail (IMN) made of Carbon-Fibre-Reinforced Polyaryl-Ether-Ether-Ketone (CFR-PEEK) for humeral shaft fracture fixation. STUDY DESIGN: A prospective, single-arm, four-centre study. PATIENTS AND METHODS: A total of 46 patients with 46 humeral fractures classified as 12 A-B were treated with a novel CFR-PEEK IMN and followed for 12 months...
November 2017: Injury
Stephan Grechenig, Gloria Hohenberger, Bore Bakota, Mario Staresinic, Peter Grechenig, Antonio Ernstberger
Humeral periprosthetic fractures are a challenging problem and their occurrence has increased, particularly over the last decade. The role of cerclage wires or cables in these fractures includes revisions with longer stems, and augmentation of a plate osteosynthesis in which the stem does not allow additional screw placement or structural bone grafts as supplementary fixation. These procedures are demanding because of the proximity of the radial nerve within the operating field. Placing a cerclage wire or cable around the fractured fragments offers a simple and safe procedure to avoid radial nerve injury or palsy in the treatment of complex humeral shaft fractures...
November 2017: Injury
Ho Min Lee, Young Sung Kim, Suk Kang, Min Young Lee, Jong Pil Kim
BACKGROUND: The authors modified the anterolateral approach for Holstein-Lewis humeral shaft fractures using a plating technique to achieve sufficient distal fixation by minimal splitting of the brachioradialis muscle to fix the most distal screws. The purpose of this retrospective study was to evaluate the efficacy of our modified anterolateral approach for Holstein-Lewis humeral fractures and document clinical and functional results. MATERIALS AND METHODS: Between 2008 and 2014, 18 patients (mean age 35...
November 2, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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